Thursday, September 22, 2016

Missing the Blog

I think about this blog frequently.  Post titles pop into my head while I'm showering.  Entire lines of text write themselves in my mind while I'm examining patients.  I am the type of person who is constantly trying to understand life, to fit it to a logical narrative, and this blog feels like an integral part of that process of understanding.  And yet, I don't make enough time for it.  Days or weeks go by without a post until I return, overwhelmed with things I want to write about, only to write a list of bullet points.

I've been working a lot lately on habits - finishing up my work efficiently, getting to the gym, staying connected with friends - and I think that blogging is going to be the next one I try to work one.  I'm finding that if I just leave things to chance that I never seem to get to them, but if I make a regular commitment of time, then I tend to get things done.  So hopefully if I make a plan for blogging I will start logging more than one or two posts per month.

Any suggestions on how frequently I should post?  If you're a blogger, how do you keep up a regular posting schedule?

Monday, September 19, 2016

Revisiting the Budget for the Millionth Time

I started writing a post about the emotional impact of medicine (thank you counseling for digging up all the painful memories and for making me feel all the feels), but it was too much for a late night blog post, so I thought I would write briefly about budgeting (yet again).

I thought I had finally solved my budget dilemma by simply increasing my daily allowance, but when I tried to put it into practice, it just didn't feel right.  I found myself alternating between feeling stressed about essential purchases like cat litter because they would put me over budget and searching for frivolous things to spend money on because there was suddenly room in my budget.  I am constantly looking for balance in my life, and the budgeting system I had used for the past two years was starting to feel very unbalanced.

(Physician On FIRE wrote a good blog post about this phenomenon here.  Definitely worth a read.)

The problem came to a head over the long weekend, when I had a nice chunk of money sitting in my budget, and I decided to spend it on a massage.  Not a utilitarian therapeutic massage, of course, but an over-the-top, self-indulgent spa massage.  Complete with a complimentary robe and slippers, assorted spa snacks, and a post-massage relaxation room to allow me to "slowly re-integrate into the outside world".  It was more than twice as expensive as any massage I'd ever had, and it made for two of the most pleasant and relaxing hours of my entire life.  Pure bliss.

But then it was over.  And after handing over a ridiculous sum of money, I was left with nothing but the memory of Renaldo's hands massaging all of the stress out of my body.  And while that is a lovely memory, it doesn't get me any closer to financial security.  Later in the day of the massage, as I was following the endless rabbit holes of the Internet, I stumbled upon a blogger's Philosophy of Money.  And one section really stood out for me:

"I want to live in such a way that I minimize the number of years that I have to work for money. I’ll have a modest house, car and lifestyle and will never spend more just because I earn more. I’ll invest any surplus so that I can live on my own terms sooner than later."

Yes.  Exactly.  Just because I'm finally earning my doctor's salary doesn't mean that I want to inflate my lifestyle to the typical doctor's lifestyle.  I want to live reasonably and modestly so that I can save any extra money and be in a position to retire early(ish).  I want freedom more than I want complimentary spa snacks.

I will never spend more just because I earn more.

So I'm revisiting the budgeting yet again.  And instead of trying to stick to a defined spending limit, I'm trying to focus on maximizing the value I get from my spending.  Whenever I make a purchase, if it isn't something I clearly need (Cat litter - yes.  Wine - kind of?), then I try to determine whether it's something that is going to enrich my life more than the time off that I could buy with the money.  Going back to the ridiculously expensive massage, I could have lived for two days at my current spending level for the cost of the massage.  If I'd invested the money for ten years, it could have bought me four days of freedom.  When viewed in that way, the decision is easy:  I would always choose two days off of work over a massage.  No matter how perfect Renaldo's hands may be.

Interestingly, this approach to budgeting seems to be working better for me so far.  I recently had to buy cat litter*, and I didn't panic over the fact that it put me over budget.  I'm currently sitting significantly under budget, and I'm not looking for things to spend money on.  I'm just trying to focus on the things that really make my life better, which can very rarely be purchased.

*Why do my cats have to eat the most expensive cat food and poop in the most expensive cat litter?  If I didn't love them so ridiculously much I could be much better off financially.

Thursday, September 1, 2016

So Many Things

You know how something happens and you think "I should blog about this", but then you don't have make the time to do it, and then something else happens that you want to blog about, but you can't because you still have to blog about the first thing, and then it happens over and over again until you have ten things you want to write about and you haven't blogged in almost a month?

Yeah.  That. 

So...because I can't decide which of the major life events I want to leave out of my blog post, and because no one wants to read a brief autobiography disguised as a blog post, here is the last month of my life in bullet points:

  1. I got back together with my (no longer) ex-girlfriend.  After the breakup, I don't think I went more than four or five days without seeing M*, and I definitely didn't go that long without talking to her.  I missed her.  We started out doing the "we're spending all our time together but not dating" thing over a month ago, and we declared ourselves dating again a few weeks ago, and so far it seems to be going well.  We're doing our best not to repeat some of the mistakes we've made in the past, and it definitely makes for a healthier relationship.  We shall see where this goes...
  2. My grandmother died.  My grandmother was 94, slightly senile, and diabetic, and yet I was convinced that she would live forever.  A few weeks ago, I got the call that she had had a heart attack and been made palliative, so I headed out to her small community as prepared as one ever is to say goodbye.  When I arrived at the hospital, she was asleep in her bed, but she quickly roused and demanded to be taken home.  By the time we got her back to the PCH, she was back to her usual feisty self, showing no signs of what had happened.  Unfortunately, a week later she fell and broke her hip (for the third time), and that was the beginning of a very rapid end.  My grandmother was the most resilient of the resilient Depression era farm women, and so it's still amazing to me that she's gone.  I still have moments when I feel guilty for not visiting her, so I don't think it's quite sunk in yet.
  3. I decided what to do with my budget.  The comments on my previous blog post were fascinating to me!  It's interesting how everyone has their own unique way of being financially responsible, many of which are different from my own.  In the end, I realized that my current method of budgeting is actually working pretty well for me, except for the fact that the amount of money I was allowing myself didn't fit with the amount of income I was bringing in.  So, I threw $500 at the budget to get myself out of the black, and I increased the regular amount in my budget by 1/3.  Since the change, I have bought Threadless t-shirts and Happy Socks, taken a thankfully not sick cat for a very expensive vet visit, and booked a luxurious spa day for the long weekend.  So I'm over budget again.  But enjoying spending some of my hard earned money instead of just hoarding it in the event of future catastrophe.
  4. I started counselling.  I wrote before about how I had seen a psychiatrist through a service at work, but what I've never written about was how abysmal the whole experience was.  I went in looking for some coping strategies and maybe some cognitive behavioural therapy for anxiety, but what I got was someone who wanted to put me on medication and explore all of the supposedly traumatic events from my childhood (um, no thanks).  It was a terrible match.  I put off looking for someone else until M and I got back together, and then I decided that I needed someone external to help me navigate the waters of rekindling an old relationship.  I've met with the counsellor once, and it seems like a better fit so far, so I'm hoping that something good will come out of it.
  5. I started exercising again.  It has become abundantly obvious to me that everything is better when I exercise.  Not in a future oriented "I won't have a heart attack when I'm 50" kind of way, but in an "I'm less of a psycho hose beast when I exercise" kind of way.  Exercise is definitely good for my stress, my energy level, my sleep, and my all round happiness.  My goal for September, in fact, is to restart the habit of exercising three times a week.  It will likely consist of me running on the treadmill on Tuesday and Thursday mornings, as I have no clinics those mornings, and then doing something else on Saturdays or Sundays.  I may alternatively do an exercise class at work on Thursday afternoons, as there's one that starts after my work day ends.  This week I'm planning to go to yoga on Saturday morning, as my sciatic pain has flared up from the running**, but I may be more creative in the future.
  6. I signed up for a meditation class.  This terrifies me.  I've been reading books about how wonderful meditation is (like 10% Happier and Full Catastrophe Living), and I'm fully convinced that it can make me a happier and more productive person, but I absolutely hate the idea of having to actually do it.  Sitting with nothing but my thoughts?  Breathing exercises?  Walking meditations?  All of that sounds terrible.  And yet, starting October 5 I will be doing it every Wednesday evening.  
And that is my life.  How is everyone else doing?

*I'm giving her an initial, because it's far too tedious to keep typing "the girlfriend" or "the ex-girlfriend" depending on my current relationship status.  Also my hands are sore from typing chart notes.

**When did I turn 80?

Sunday, August 7, 2016

The End of Budgeting?

My budget is currently sitting at $294.13 in the red.  A year ago, when I was just starting to work and I was trying to dig myself out of nine years of medical school debt, this would've caused me to panic.  Or more realistically, I never would've gone $294.13 into the red.  I would've eaten rice and beans and said no to get togethers with friends to keep myself from ever going over budget.

Now, I barely notice.  When I hit a positive net worth, my stress level about money dropped, and I have gradually gotten less and less worried about money as my savings have climbed.  Slowly, I've reintroduced things into my life that I've forgone over the past two years:  fancy drinks in restaurants, expensive cheeses, clothing of any sort.  And it feels really nice.

I'm not entirely sure what to do about budgeting at this stage.  Even with being over budget, I'm saving over 2/3 of my earnings, so I am more than meeting my financial goals.  I don't really have to budget anymore; and yet, there is part of me that doesn't want to abandon budgeting altogether.  Part of it is for the reasons I outlined in a long ago post about why I continue to be relatively frugal.  But it's more than that.

I think a huge part of me worries that I'll go back to my terribly consumeristic ways if I stop budgeting.  Before I started budgeting two years ago, I had developed an almost instinctual habit of buying whatever I wanted.  Whether I was shopping for clothes or eating in a nice restaurant or ordering books online, I would simply buy whatever appealed to me in the moment with the knowledge that it was going on my line of credit and I wouldn't have to pay for it until I was an attending*.  I would take whatever boredom or loneliness or exhaustion I was feeling and try to spend it away.  Always unsuccessfully.

Starting to budget made me much more mindful of my spending.  It made me realize that I often wasn't looking for a new thing when I went shopping, but rather for some feeling that I was missing.  A lot of the time, the best thing I could do when I felt like buying something at random was to just go have a nap, as I've been chronically tired since my first day of medical school in 2006.  It also made me focus on non material ways of being happier, rather than on buying a new pair of happy socks.  (Although I really love happy socks.  And am now searching their website thinking about placing an order.  Well done, me.  You've clearly learned your lesson.)

I guess what I'm looking for is some way to be intentional with my spending while not feeling constantly constrained by my budget.  I want to take advantage of the fact that I'm earning ridiculous amounts of money for a single woman with no dependents, without thinking that I can somehow buy happiness.  Balance.  The endless search for balance.

Any ideas?

*Thank you very much, past me.  You are an asshole.


To update you on my habits from a few weeks ago, I've been doing surprisingly well with them.  I have completely resisted the cans of Coke in my fridge, and I've passed on pop multiple times in restaurants.  I am allowing myself to have pop in mixed drinks (something I decided to do in the beginning but didn't mention in my previous post because I was lazy), but in total it's been about one can of pop since I started.  I almost always put my things where they belong when I get home, which has made leaving in the morning much more efficient and peaceful.  I've also started putting my keys/wallet/phone in specific spots in my bag (my bag has about 8 different spots, so searching for something can be frustrating), and that has also been a huge improvement.  Finally, I have planned out my weekly schedule every Sunday night, and it has given me a bit more awareness of the week and a big more structure.  It also saved me from missing dinner with a good friend this week (I thought it was on Thursday, but it's actually on Tuesday), so that is also a win.

Well done, me. 

Sunday, July 24, 2016

Back to Work

I've taken a lot of vacation already this summer.  In May, it was Egypt/Greece/Jordan with my (now ex-) girlfriend.  In June, it was Chicago with my family.  This month, I spent a weekend in New York City for a wedding and then took a week off at home so that I could go to our local theatre festival, which is pretty much my favourite thing in the world.  Unfortunately, today was the last day of the festival, and tomorrow I go back to work.

There is actually a small part of me that is looking forward to going back.  Despite my Facebook posts to the contrary*, I mostly enjoy my job, and I am happy to have a bit more routine in my life again.  The past month and a half has felt very unsettled, and I'm hoping that being back at work will help me to feel more grounded.  More like myself again.

As I prepare to go back for a long stretch with no vacation in sight**, I have been thinking a lot about happiness - specifically, about things that I can do to be happier in both the short and the long term.  Find a new girlfriend seems to be the one that pops into my head most readily, but I'm well aware that I'm not yet in a place where I should start dating again, so I will just try my best to ignore that thought for at least a few more months.  Beyond that, there isn't one single thing that comes to mind; rather, there's a long list of small things that might help to make my life easier and better.  So...I'm back to trying to make some small habit changes

At the moment, there are three things that I'm trying to work on, which I will discuss very briefly, because it is suddenly late, and I have to set an alarm clock for the first time in 11 days.

Stop drinking pop: 

I know that I need to make healthier food choices, and I also know that sudden radical changes inevitably lead to failure, so I'm going to start small.  I gave up pop for the month of April, and I was really surprised by how little I missed it.  At the beginning of the month, I though about drinking it periodically, but the cravings for it always passed quickly, and by the end of the month I didn't even think about it.  I was actually a few days into May before I realized that I could start drinking pop again.  Which I wish I hadn't. 

Put my keys, wallet, and cell phone in the same place when I come home:

I am ashamed to admit that I spend a lot of time searching for my keys, wallet, and cell phone.  I frequently switch them between my purse, my work bag, and an assortment of backpacks that I use when I'm out at festivals or other events, and I can never seem to find them when I need them.  Not to mention the fact that my cell phone is rarely charged, which is inconvenient given that I recently gave up my land line.  A few days ago, I moved a storage unit into my front hallway and put a wicker basket on top of it, and I am trying very hard to put my things into it whenever I get home.  Except for the cell phone, which is getting attached to the charger.

Review my schedule on a weekly basis:

I'm pretty good about entering events into my calendar, but I'm not the best at subsequently looking at the calendar and remembering what I need to do.  So far I haven't missed any major appointments (in recent history, at least), but this leaves me with a bit of an unsettled feeling all the time.  My plan is to spend a bit of time every Sunday reviewing my schedule for the week (work and home) and to make a few work/personal goals for the week.  I will never come anywhere near sarah (SHU) in my organizational skills, but I am hoping to slowly improve them.

And that's it.  Three small habits that will not radically change my life but that will hopefully make things a bit better.  And once I've adopted these habits, there can always be more! 

*My Mom freaked out when I recently posted on Facebook that I preferred being at the theatre festival to being at work.  What would your patients think if they saw that?  Um...that I'm a normal human being who sometimes likes vacation more than being at work.

**Any ideas of fun things for single people to do on vacation?  The thought of booking a holiday without my (now ex-) girlfriend makes me want to vomit in my mouth a little, but I know that I will eventually need to go somewhere without her.  Or just work all the time.  Also an option.

Monday, July 18, 2016

In the Gloaming

Given the recent end of my long-term relationship, you probably won't be too surprised to hear that my emotional state has been a bit volatile as of late.  One moment I'm feeling excited by the freedom and possibility that being single brings; the next moment I'm overwhelmed by sadness at everything that has been lost.  While I have still managed to do all of the things that I need to, getting through the days hasn't always felt great.

Tonight though, things were momentarily really good.  I had to bring my bike home from my ex-girlfriend's parents' house, where I had stored it over the winter, and I just happened to do so right at dusk.  The temperature was warm enough to be comfortable but cool enough that I didn't break a sweat; the air was still; and the clear sky transformed from pale blue to pink to indigo as I rode the bike home.  My out of shape muscles enjoyed being challenged, and my constantly busy mind reveled in being able to shift down a few gears.  It was as close to perfect as life ever gets.

I have gotten through the past few weeks by constantly reminding myself that things will get better.  Tonight though, if only for a brief moment, things already were.

Sunday, July 3, 2016

Taking the Real World with You

When I went to Chicago for the first time in 2012, I had just finished my first month as a senior resident in a Medical-Surgical Intensive Care Unit.  That rotation was one of the most difficult months of my entire training.  My medical knowledge and patient management skills were challenged beyond anything I had ever experienced, and I lived in constant fear that my ignorance and/or incompetence was going to kill someone.  With only three residents in the unit, we were forced to take call every third night*, such that I was making difficult patient care decisions through a haze of severe sleep deprivation. 

And then there were the patients.

Because the unit was home to the sickest patients in the hospital, death was a constant presence.  The worst night of my training happened in that unit:  over the course of a 15-hour overnight period, I admitted or ran a code on eight patients, not a single one of whom survived to the morning**.  At 8 am, one of my co-residents walked into the unit, looked at the near-empty patient list, and nonchalantly commented "Oh, looks like you had a quiet night".  In another situation her comment would've made me bawl, but I was too emotionally drained to do anything more than put my head on the desk and moan.  It was a hard month.

My ICU rotation was followed by two weeks of vacation, which I had initially planned to spend relaxing at home and visiting with friends and family.  But as I dragged myself through the too-long days of ICU, subsisting on digestive biscuits and ice cream cups that were intended for patients, I knew that I needed something better to look forward to in order to make it to the end of the rotation.  So, a few days before I was finished with ICU, while lying nearly immobile on my couch in a post-call stupor, I booked an impromptu trip to Chicago.  Leaving at 6 am on the first day of my vacation.

It was an amazing trip.  Chicago was a beautiful city filled with interesting places to visit and a seemingly unending list of great places to eat.  The weather was perfect.  I lucked out and got a great hotel room on the 22nd floor that looked directly towards the Chicago River and the Wrigley Building.  And for one week I didn't have to take orders or give orders or feel people's pulses slip away as I held my hand over their femoral arteries.  It was the perfect escape.

I had hoped that my trip to Chicago this past weekend would be just as amazing.  And I will say that it was mostly fun, lest I seem ungrateful for having the good fortune to be able to travel to such a remarkable place.  I got to show my Mom a city that I love; I got to meet Carlos from Top Chef season 11 and eat in his amazing restaurant; and I left the pressures of work behind for four days.


My family is not always easy.  My Mom is going through a difficult period, still struggling to cope with the death of my father six years ago, and there was understandably a lot of time and attention devoted to what she's going through.  She also snores.  Loudly.  And unpredictably.  I spent the first night on the couch to get away from her, and the second night I severely pissed her off by making her sleep in my brother's room.  Thankfully he is so perpetually exhausted that he can sleep through anything.

And then there's my brother.  While I love him (really...I love him), he and I see the world through very different lenses***.  I am an unapologetically left-wing, environmentally minded, socialistic granola cruncher.  My brother takes ten napkins at Chipotle and throws out nine unused ones.  If we could simply agree to disagree, we would probably get along much better; however, we both think that we have all the answers to the world's problems, and we are determined to share them with each other.  So there was some conflict.  He said I was judgemental.  I may have called him an asshole.

The good thing about family is that they are always your family.  Even if you call them an asshole.

*The resident contract in my province stipulates that residents cannot take call more than once every four days, on average; however, in situations where "patient care would otherwise be compromised", that rule can be overlooked.  Hence the one-in-three call.

**I refuse to believe that this reflects on my skill as a physician in any way.  The patients were simply that sick.  Most of them didn't make it to the end of the code blue.

***Thankfully he isn't a Trump supporter.  There are some things that I cannot forgive, even when it's family.